Even with revisions, Senate health bill still hurts far more than it helps

Personal tales of health insurance price hikes, such as the steep increases faced by Jennifer and Michael Rupprecht of rural southeastern Minnesota, played a key role in persuading state lawmakers last January to pass a temporary rate relief program.

Like many Minnesotans who buy private insurance on their own, the Rupprechts, who farm near Lewiston, faced double-digit increases for 2017 coverage. The two-year aid package to reduce consumers' costs was never meant to be a permanent fix, but something like it needs to stay in place well beyond 2018 for the couple to continue to afford coverage.

The reason: The health reform plans congressional Republicans are pushing through Congress would provide far less help than President Barack Obama's Affordable Care Act when it comes to assisting people like the Rupprechts who are struggling to buy health insurance.

Both the U.S. Senate and U.S. House reform plans are serious steps backward for most who buy insurance on their own instead of getting it through an employer or a government program, a key reason why neither merits passage. Both plans would increase comprehensive insurance costs to most consumers — especially those in their 50s and 60s — while decreasing eligibility for financial subsidies first made available under the Obama health law.

The changes allow older people to be charged five times more than younger people. Under the Obama law, this was capped at three times more. Both GOP plans also lower the eligibility threshold for premium payment assistance from 400 percent of the federally set poverty income level to 350 percent.

Revisions to the Senate bill, which were released Thursday, were an opportunity to fix these harsh changes. Regrettably, the Senate's Better Care Reconciliation Act (BCRA) left them in place while making other dubious changes — namely, Texas Republican Sen. Ted Cruz's amendment — that would destabilize the individual health insurance market and make comprehensive coverage even less affordable. The Cruz measure would allow people to buy skimpy policies that are cheap but cover very little. The result: Costs will soar for those who want real coverage — such as policies that cover cancer treatment, for example.

The Rupprechts illustrate how many consumers' pocketbooks will take a bigger hit under the Senate bill. They are about five years away from the Medicare eligibility age of 65, when the federal government's popular health insurance program for seniors kicks in. The couple need comprehensive coverage because of their age and because they farm. As Jennifer Rupprecht puts it, "accidents happen."

A Kaiser Family Foundation calculator that takes into account Jennifer Rupprecht's age, income and home county offers a sobering comparison of how she'd fare under the Obama law vs. the BCRA. By 2020, the premium for a comprehensive health insurance plan under the Obama law would rise to $16,670. Under the BCRA, it would be $22,390.

Doubling those numbers, necessary to cover her husband, shows why she stays awake at night worrying about coverage. The decision they ultimately face, Jennifer Rupprecht said, is "whether or not to purchase health insurance.'' It's easy to see why the number of uninsured Americans is expected to soar if the BCRA or the House version of it passes.

The newly revised Senate bill will still hurt many of the insurance consumers the party claims it is trying to help. The Star Tribune Editorial Board has also long sounded the alarm about steep cuts the bill proposes for the publicly funded Medicaid program, which covers kids, nursing home residents and the disabled. These unconscionable cuts are still in place. Senators who face an expected floor vote next week should put their constituents' health before President Donald Trump's need for a political "win" and vote no.